How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $31.62 | Professional | None | $23.44 | $23.44 | $31.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $27.54 Median $36.31 Typical High $48.98 | Professional | None | $27.54 | $36.31 | $48.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.09 Median $3.63 Typical High $4.68 | Professional | RR · Rental | $3.09 | $3.63 | $4.68 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $23.44 Median $27.54 Typical High $34.67 | Professional | UE · Used equipment | $23.44 | $27.54 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
ConnectiCare Setting Professional Modifier None Typical Low $48.98 Median $83.18 Typical High $97.72 | Professional | None | $48.98 | $83.18 | $97.72 |
United Setting Professional Modifier None Typical Low $18.20 Median $21.88 Typical High $38.02 | Professional | None | $18.20 | $21.88 | $38.02 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $11.75 Median $11.75 Typical High $15.85 | Professional | 52 · Reduced service | $11.75 | $11.75 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $4.68 Typical High $6.31 | Professional | 53 · Discontinued | $4.68 | $4.68 | $6.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $17.38 Median $17.38 Typical High $23.99 | Professional | 54 · Surgery only | $17.38 | $17.38 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $3.55 Typical High $4.79 | Professional | 55 · Aftercare only | $3.55 | $3.55 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $2.34 Typical High $3.16 | Professional | 56 · Pre-op care only | $2.34 | $2.34 | $3.16 |
Where Connecticut sits
The same service costs 2.7 times more in Hawaii than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Connecticut· 24th of 51
$30.90
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.